| NPI | 1013532506 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | MICHAEL ROBERT GALLUCCI Dentist 401-533-3108 |
| Organization Subpart ? | No |
| Primary Taxonomy | 122300000X Dentist |
| Additional Taxonomies | 1223P0700X Dentist, Prosthodontics |
| Enumeration Date | 2020-06-10 |
| Last Update Date | 2020-06-10 |